NCC EFM Certification Exam 2026 –
Electronic Fetal Monitoring Actual Test
Bank with Verified Questions and
Rationales | Graded A | 100% Pass
Guarantee
Category I, II, III FHR Tracings (NICHD Classification)
1. A fetal heart rate (FHR) tracing shows baseline 135 bpm, moderate variability,
accelerations, and no decelerations. This tracing is classified as:
A) Category I
B) Category II
C) Category III
D) Indeterminate
Correct: A – Category I
Rationale: Category I tracings require all of the following: baseline 110–160 bpm,
moderate variability (6–25 bpm), no late or variable decelerations, with or without
accelerations. This is a normal, reassuring tracing.
,2. A Category III FHR tracing requires the presence of:
A) Minimal variability with recurrent late decelerations
B) Absent baseline variability with recurrent late decelerations or bradycardia
C) Moderate variability with recurrent variable decelerations
D) Tachycardia with early decelerations
Correct: B – Absent baseline variability with recurrent late decelerations or
bradycardia
Rationale: NICHD defines Category III as: absent baseline variability plus recurrent
late decelerations, recurrent variable decelerations, or bradycardia. Category III
indicates abnormal, non-reassuring tracing requiring immediate intervention.
3. A Category II FHR tracing is best described as:
A) Normal and reassuring
B) Abnormal requiring immediate delivery
C) Not predictive of normal fetal acid-base status but not frank acidosis
D) Always requires cesarean section
Correct: C – Not predictive of normal fetal acid-base status but not frank
acidosis
Rationale: Category II tracings are indeterminate. They are not normal (Category I)
nor frankly abnormal (Category III). They require continued surveillance and may
need intervention if they worsen.
Baseline FHR & Variability
,4. The normal baseline FHR range for a term fetus is:
A) 100–150 bpm
B) 110–160 bpm
C) 120–180 bpm
D) 90–140 bpm
Correct: B – 110–160 bpm
Rationale: NICHD defines normal baseline FHR as 110–160 bpm for a term fetus.
Bradycardia is <110 bpm; tachycardia is >160 bpm for ≥10 minutes.
5. A fetal heart rate baseline of 175 bpm lasting 15 minutes is classified as:
A) Normal
B) Bradycardia
C) Tachycardia
D) Baseline variability
Correct: C – Tachycardia
Rationale: Tachycardia is baseline FHR >160 bpm for ≥10 minutes (NICHD).
Causes include maternal fever, chorioamnionitis, fetal hypoxia, or medications.
6. Moderate variability is defined as FHR fluctuations of:
A) Undetectable amplitude
B) ≤5 bpm amplitude
C) 6–25 bpm amplitude
D) >25 bpm amplitude
, Correct: C – 6–25 bpm amplitude
*Rationale: Moderate variability (6–25 bpm) is normal and reassuring. Absent =
undetectable; minimal = ≤5 bpm; marked = >25 bpm.*
7. A Category I tracing must have which type of variability?
A) Absent
B) Minimal
C) Moderate
D) Marked
Correct: C – Moderate
Rationale: Category I requires moderate variability (6–25 bpm). Absent or minimal
variability with other findings may make the tracing Category II or III.
8. Which condition is most likely to cause absent or minimal variability in a term
fetus?
A) Fetal sleep cycle
B) Maternal fever
C) Fetal acidosis or CNS depression
D) Uterine contractions
Correct: C – Fetal acidosis or CNS depression
*Rationale: Prolonged absent/minimal variability (over 60 minutes) may indicate
fetal acidemia, neurologic injury, or CNS depressant drugs (magnesium, narcotics).
Fetal sleep cycles last <30 minutes.*
Electronic Fetal Monitoring Actual Test
Bank with Verified Questions and
Rationales | Graded A | 100% Pass
Guarantee
Category I, II, III FHR Tracings (NICHD Classification)
1. A fetal heart rate (FHR) tracing shows baseline 135 bpm, moderate variability,
accelerations, and no decelerations. This tracing is classified as:
A) Category I
B) Category II
C) Category III
D) Indeterminate
Correct: A – Category I
Rationale: Category I tracings require all of the following: baseline 110–160 bpm,
moderate variability (6–25 bpm), no late or variable decelerations, with or without
accelerations. This is a normal, reassuring tracing.
,2. A Category III FHR tracing requires the presence of:
A) Minimal variability with recurrent late decelerations
B) Absent baseline variability with recurrent late decelerations or bradycardia
C) Moderate variability with recurrent variable decelerations
D) Tachycardia with early decelerations
Correct: B – Absent baseline variability with recurrent late decelerations or
bradycardia
Rationale: NICHD defines Category III as: absent baseline variability plus recurrent
late decelerations, recurrent variable decelerations, or bradycardia. Category III
indicates abnormal, non-reassuring tracing requiring immediate intervention.
3. A Category II FHR tracing is best described as:
A) Normal and reassuring
B) Abnormal requiring immediate delivery
C) Not predictive of normal fetal acid-base status but not frank acidosis
D) Always requires cesarean section
Correct: C – Not predictive of normal fetal acid-base status but not frank
acidosis
Rationale: Category II tracings are indeterminate. They are not normal (Category I)
nor frankly abnormal (Category III). They require continued surveillance and may
need intervention if they worsen.
Baseline FHR & Variability
,4. The normal baseline FHR range for a term fetus is:
A) 100–150 bpm
B) 110–160 bpm
C) 120–180 bpm
D) 90–140 bpm
Correct: B – 110–160 bpm
Rationale: NICHD defines normal baseline FHR as 110–160 bpm for a term fetus.
Bradycardia is <110 bpm; tachycardia is >160 bpm for ≥10 minutes.
5. A fetal heart rate baseline of 175 bpm lasting 15 minutes is classified as:
A) Normal
B) Bradycardia
C) Tachycardia
D) Baseline variability
Correct: C – Tachycardia
Rationale: Tachycardia is baseline FHR >160 bpm for ≥10 minutes (NICHD).
Causes include maternal fever, chorioamnionitis, fetal hypoxia, or medications.
6. Moderate variability is defined as FHR fluctuations of:
A) Undetectable amplitude
B) ≤5 bpm amplitude
C) 6–25 bpm amplitude
D) >25 bpm amplitude
, Correct: C – 6–25 bpm amplitude
*Rationale: Moderate variability (6–25 bpm) is normal and reassuring. Absent =
undetectable; minimal = ≤5 bpm; marked = >25 bpm.*
7. A Category I tracing must have which type of variability?
A) Absent
B) Minimal
C) Moderate
D) Marked
Correct: C – Moderate
Rationale: Category I requires moderate variability (6–25 bpm). Absent or minimal
variability with other findings may make the tracing Category II or III.
8. Which condition is most likely to cause absent or minimal variability in a term
fetus?
A) Fetal sleep cycle
B) Maternal fever
C) Fetal acidosis or CNS depression
D) Uterine contractions
Correct: C – Fetal acidosis or CNS depression
*Rationale: Prolonged absent/minimal variability (over 60 minutes) may indicate
fetal acidemia, neurologic injury, or CNS depressant drugs (magnesium, narcotics).
Fetal sleep cycles last <30 minutes.*
